Pericardial mesothelioma attacks the membranous lining of the heart, called the pericardium or the pericardial sac. Pericardial mesothelioma is a very rare form of malignant mesothelioma, totaling only about five percent of all malignantmesothelioma cases. It is caused by exposure to deadly asbestos fibers, but how that happens is a matter of debate. The common belief is that the asbestos fibers start in the lungs and travel to the heart through the bloodstream, where they become lodged in the pericardium and eventually, after 20 to 50 years, lead to pericardial mesothelioma. Malignant tumor cells grow in the pericardium, causing the membranes to thicken and fill with fluid. In the later stages of the cancer, the tumors put pressure on the heart and cause a variety of symptoms.
Treatment options are limited in the case of pericardial mesothelioma, and the prognosis is rarely good. Because the cancer is almost impossible to detect early, and the proximity to the heart often makes surgery difficult of impossible, the average patient dies within six months of diagnosis. Occasionally, pericardial mesothelioma is caught early enough for successful treatment options, usually when a physician is looking for something else.
Surgery
Most pericardial mesothelioma patients do not qualify for any kind of surgery aside from palliative procedures.
The most common surgery for a pericardial mesothelioma patient is a fine needle aspiration, called pericardiocentesis, where a surgeon inserts a thin needle into the pericardial sac and drains the fluid from around the heart. This palliative and diagnostic procedure relieves pain and pressure. The fluid is tested to aid in diagnosis and treatment.
Chemotherapy
Chemotherapy refers to chemical treatments designed to kill cells and may take the form of pills, injections, intravenous treatments. In the case of pericardial mesothelioma, chemotherapy, like any treatment, can prove dangerous or deadly. In addition to a long list of unpleasant side effects, anything used to kill the cancer cells surrounding the heart will also kill heart tissue.
Radiation
Ionizing radiation is a procedure used to kill cancerous cells and slow the growth rate of the cancer. While radiation is effective for some forms of cancer, it can be deadly for pericardial mesothelioma patients, because it kills healthy tissue surrounding the affected area, which includes the heart and the protective tissues around the heart.
Intensity-modulated radiation therapy (IMRT) may prove to be the most viable radiation treatment for pericardial mesothelioma patients. It is a new procedure that uses an advanced computer-controlled, high-precision radiotherapy to deliver radiation exactly where it’s needed, with very little damage to surrounding tissues. Little information is available about the use of IMRT to specifically treat pericardial mesothelioma, possibly because pericardial mesothelioma is so rare.
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